Leah Trombley, M.A., BCBA, has worked with many youngsters on the autism spectrum who have come to Gateway Pediatric Therapy almost completely nonverbal. Through Applied Behavior Analysis (ABA) therapy, many of these children have gone on to develop functional communication skills that have enabled them to appropriately communicate their wants and needs to their loved ones.
“The sooner a child begins ABA therapy, the sooner he or she is presented with learning opportunities that can help with communication, social and adaptive skills while reducing maladaptive behaviors,” says Trombley, Clinical Director of Gateway’s Shelby Township location.
ABA is an evidence-based intervention often used with individuals on the autism spectrum. The goal of ABA therapy is to increase behaviors that are helpful while reducing those that may be a barrier to learning. After setting ABA therapy goals with a child’s family, Gateway team members will work one on one with a child to positively reinforce desired behaviors.
“Quite frequently treatment plan goals will be to help the child on the autism spectrum with their language and communication,” Trombley notes. “We’ll work with them across different skill areas such as labeling items and requesting things they need or want in an appropriate way that ultimately helps them become more independent.”
Trombley says that ABA therapy can also help a child develop adaptive skills related to activities of daily living. These activities could include brushing one’s teeth, getting dressed or using the bathroom.
“With ABA, we work on imitation quite a bit,” she says. “First, the child observes the clinician modeling the target response, then after implementation of reinforcement strategies the child eventually begins to imitate it.” Imitation can differ across a variety of responses, such as gross motor, fine motor, oral motor, or vocal.
When it comes to reducing maladaptive behaviors, ABA therapy often plays a key role there as well. Examples of maladaptive behaviors include non-function screaming or crying, falling to the floor with transitions, property destruction, self-stimulation, aggression toward others, or even self-injury.
“Generally, these maladaptive behaviors serve some function for the child,” Trombley explains. “He might be screaming in order to gain access to something he wants, and that’s the only way he knows to communicate.”
With ABA therapy, clinicians work with a child in this situation to increase functional communication such as making a vocal approximation or exchanging a picture icon on his or her Picture Exchange Communication System (PECS) instead of screaming or exhibiting some other maladaptive behavior.
Trombley recommends early intervention with ABA therapy in order to begin working on socially significant skills when a child is still at those critical stages of early learning.
“While ABA therapy can be helpful to a child of any age, it can be especially helpful to very young children,” she notes. “Research has shown that early intervention is key to a child’s overall development and well-being.”
Trombley advises parents who have observed that their young child is not meeting developmental milestones to consult their child’s doctor.
“Parents should discuss their concerns and whether ABA therapy may be an appropriate avenue to pursue,” Trombley says. “Intervention can begin as early as 18 months.”
Trombley notes that the number of hours per week of ABA therapy recommended for a child on the spectrum varies widely depending on the child’s unique needs.
“A hallmark of ABA therapy at Gateway is a customized approach,” Trombley says. “Treatment procedures and teaching instructions are individualized and specifically designed to address the skills needed by each individual child so he or she can function optimally in a variety of environments.”
ABA therapy may take place in the clinic setting, in the child’s home, or out in the community, again dependent on his or her unique needs. A Gateway clinician will develop a treatment plan based on the child’s assessed skill levels. The plan provides the basis for ABA treatment programming delivered by a Gateway technician. The technician will work to identify a child’s motivation, which can then be used to positively reinforce correct responses.
“ABA therapy is not always meant to go on indefinitely,” Trombley adds. “We work with the child to achieve established goals. As he or she progresses, and meets those desired skill outcomes that will allow them to integrate into a less structured environment, we can gradually transition him or her to a less intensive learning environment. With early intervention, we focus on those skills that the child will need to have outside of the one-on-one therapy environment so that they can generalize those skills in other settings.”
For more information on the services provided by Gateway Pediatric Therapy, call 248-221-2945 or visit www.gatewaypediatrictherapy.com.